News from the Political Front
2017. Has there ever been a new year when national headlines have been so dominated by significant developments effecting our societal attitudes toward substance abuse and addiction?
Almost lost just prior to the holiday season was the Surgeon General’s Report on Alcohol, Drugs and Health, marking the first time the top health official in the US has submitted a report on substance abuse and correlating issues. The report, titled “Facing Addiction in America,” discusses findings about alcohol, illegal drugs, and prescription drug abuse, while also discussing neurobiology, prevention, treatment, recovery, health systems integration, and advice for the future.
It also takes an in-depth look into the chemistry of substance abuse and addiction, addressing the need for a paradigm shift in the way Americans talk about the issue to end the cycle of stigma and shame. The report goes on to recommend actions for prevention and treatment for those who need help. The report represents the first attempt by anyone in any US administration to approach substance use and addiction not as an ethical issue or a matter of criminality, but as a human experience to be understood, as a human dilemma calling for a humane response.
“Once viewed largely as a moral failing or character flaw,” the report says, addictions are “now understood to be chronic illnesses characterized by clinically significant impairments in health, social function, and voluntary control over substance use” (US Department of Health and Human Services, 2016). It sees addiction as a chronic illness, to be treated as other medical conditions such as diabetes or asthma.
Most importantly, “Facing Addiction in America” is a sure sign of progress in the efforts to eliminate the stigma of addiction and recovery—a comprehensive take on recovery that will help to better inform policymakers, the medical community, and the public from an authoritative standpoint. A comprehensive approach like this is crucial in addressing alcohol and drug addiction, as it includes the expanding role of recovery housing, recovery communities in education (both high school and college), and recovery organizations around the nation.
In the same week as the release of the Surgeon General’s report, Congress passed the 21st Century Cures Bill, a sweeping $6.3 billion medical innovation bill. Alongside the Cures Bill, The Comprehensive Addiction and Recovery Act (CARA) also passed, providing $1 billion over two years in grants to states to address the opioid addiction crisis through prevention, treatment, prescription drug monitoring programs and workforce development.
The Cures Act passed with bipartisan congressional support and with the support of the White House. The bill also creates federal drug courts and programs for alternatives to incarceration for individuals with SUDs. It also encourages integration of care for SUDs with primary care.
These are major victories for our field. As noted by Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers (NAATP) in his year-end message, “These are remarkable advances in terms of society’s recognition of addiction as a health care matter, and policy-makers’ willingness to act. They provide the service provider with real tools. Rarely, if ever, have we seen this quantity and quality of addiction service public policy” (2016).
As of this writing, there is far less certainty about the future of the Affordable Care Act (ACA), also known as “Obamacare.”
An article by the Partnership for Drug-Free Kids states,
Almost 30 percent of people who received coverage through the ACA’s Medicaid expansion have a mental disorder or a substance use disorder, according to the Substance Abuse and Mental Health Services Administration. Partially repealing ACA would do away with Medicaid expansion, and would most likely replace it with block grants that would require states to make cuts in what is covered, how much is spent and how many people can receive coverage (2017).
Let’s hope the glass remains at least half full.
Partnership for Drug-Free Kids. (2017). Repeal of Obamacare could reduce coverage for addiction treatment. Retrieved from http://www.drugfree.org/news-service/repeal-obamacare-reduce-coverage-addiction-treatment/
US Department of Health and Human Services. (2016). Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. Retrieved from https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf
Ventrell, M. (2016). 2016: A year of progress and positioning. Retrieved from https://www.naatp.org/resources/news/2016-year-progress-positioning/dec-21-2016